Analgesic efficacy of cerebral and peripheral electrical stimulation in chronic nonspecific low back pain: a randomized, double-blind, factorial clinical trial

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art_HAZIME_Analgesic_efficacy_of_cerebral_and_peripheral_electrical_stimulation_2015.PDF (571.03 KB)
Citações na Scopus
15
Tipo de produção
article
Data de publicação
2015
DOI
Scopus
Web of Science
Título da Revista
ISSN da Revista
Título do Volume
Editora
BIOMED CENTRAL LTD
Autores
FREITAS, Diego Galace de
MARETTO, Rafaela Lasso
CARVALHO, Nilza Aparecida de Almeida
Citação
BMC MUSCULOSKELETAL DISORDERS, v.16, article ID 7, 8p, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Chronic non-specific low back pain is a major socioeconomic public health issue worldwide and, despite the volume of research in the area, it is still a difficult-to-treat condition. The conservative analgesic therapy usually comprises a variety of pharmacological and non-pharmacological strategies, such as transcutaneous electrical nerve stimulation. The neuromatrix pain model and the new findings on the process of chronicity of pain point to a higher effectiveness of treatments that address central rather than peripheral structures. The transcranial direct current stimulation is a noninvasive technique of neuromodulation that has made recent advances in the treatment of chronic pain. The simultaneous combination of these two electrostimulation techniques (cerebral and peripheral) can provide an analgesic effect superior to isolated interventions. However, all the evidence on the analgesic efficacy of these techniques, alone or combined, is still fragmented. This is a protocol for a randomized clinical trial to investigate whether cerebral electrical stimulation combined with peripheral electrical stimulation is more effective in relieving pain than the isolated application of electrical stimulations in patients with chronic nonspecific low back pain. Methods/Design: Ninety-two patients will be randomized into four groups to receive transcranial direct current stimulation (real/sham) + transcutaneous electrical nerve stimulation (real/sham) for 12 sessions over a period of four weeks. The primary clinical outcome (pain intensity) and the secondary ones (sensory and affective aspects of pain, physical functioning and global perceived effect) will be recorded before treatment, after four weeks, in Month 3 and in Month 6 after randomization. Confounding factors such as anxiety and depression, the patient's satisfaction with treatment and adverse effects will also be listed. Data will be collected by an examiner unaware of (blind to) the treatment allocation. Discussion: The results of this study may assist in clinical decision-making about the combined use of cerebral and peripheral electrical stimulation for pain relief in patients with chronic low back pain.
Palavras-chave
Chronic back pain, Transcranial direct current stimulation, Transcutaneous electrical nerve stimulation, Randomized clinical trial, Factorial design
URI
https://observatorio.fm.usp.br/handle/OPI/9352
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MFT
Artigos e Materiais de Revistas Científicas - LIM/34